Tumor Lysis Syndrome
Summary of Key Points
• Tumor lysis syndrome can occur in any patient with newly diagnosed or relapsed cancer, and thus all patients should undergo risk stratification and management according to their risk for clinical tumor lysis syndrome.
• Laboratory tumor lysis syndrome is defined as the presence of two or more of the following abnormalities present on the same day: hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia as a result of hyperphosphatemia.
• Clinical tumor lysis syndrome is defined as laboratory tumor lysis syndrome plus acute kidney injury, symptomatic hyperkalemia, or symptomatic hypocalcemia, and it should be prevented whenever possible.
• The incidence of clinical tumor lysis syndrome depends on the number of risk factors present at presentation and on the management of patients potentially at risk.
• Risk factors for clinical tumor lysis syndrome include a large cancer mass, high cell lysis potential (chemosensitivity), and patient factors (e.g., preexisting nephropathy, dehydration, acidosis, hypotension, and nephrotoxin exposure).
• Management depends on the risk of the development of clinical tumor lysis syndrome:
Negligible risk—no prophylaxis, no monitoring
